Official Summary Text
HB2435 - 572R - House Bill Summary
ARIZONA HOUSE OF REPRESENTATIVES
57th
Legislature, 2nd Regular Session
Majority Research Staff
House
: HHS DPA 7-5-0-0
HB
2435
: internationally trained physicians; licensure
Sponsor:
Representative Bliss, LD 1
House
Engrossed
Overview
Requires
applicants who attended a foreign school of medicine, successfully completed
all formal graduation requirements and satisfied all requirements of Pathway One
through the
Educational
Commission for Foreign Medical Graduates and meets
to be granted a provisional medical
license if the applicant meets all other applicable criteria.
History
Basic
Requirements for Medical Licensure
The purpose of the
Arizona Medical Board (AMB) is to protect the public from unlawful,
incompetent, unqualified, impaired or unprofessional practitioners of
allopathic medicine through licensure, regulation and rehabilitation of the
profession in Arizona.
An applicant for a
medical license in Arizona must: 1) graduate from an approved school of
medicine or receive a medical education that the AMB deems to be of equivalent
quality; 2) successfully complete an approved 12-month hospital internship,
residency or clinical fellowship program; 3) have the physical and mental
capability to safely engage in the practice of medicine; 4) have a professional
record that indicates that the applicant has not committed any act that would
constitute grounds for disciplinary action; 5) not have surrendered a license,
currently be under investigation, suspension or restriction or have had a
medical license revoked by a medical regulatory board in another jurisdiction
that constitutes unprofessional conduct; 6) pay all AMB-required fees; 7)
complete an AMB-prescribed training unit; 8) submit a five-year medical
employment history including verification of licensure from every state in
which the applicant has ever held a medical license; and 9) submit a full set
of fingerprints to the AMB for a state and federal criminal records check
(A.R.S. �
32-1422
). An applicant for a medical
license in Arizona who has graduated from an unapproved school of medicine must
meet additional outlined requirements.
Students
Graduating from an Unapproved Allopathic School of Medicine
In addition to the
basic requirements for licensure, any applicant who has graduated from an
unapproved school of medicine must meet each of the following requirements: 1)
be able to read, write, speak, understand and be understood in the English
language; 2) hold a standard certificate issued by the Educational Commission
for Foreign Medical Graduates (ECFMG), complete a Fifth Pathway Program or
complete 36 months as a full-time assistant professor or in a higher position
in an approved school of medicine; and 3) successfully be enrolled in an
approved 24-month hospital internship, residency or clinical fellowship
program, in addition to the 12 months, for a total of 36 months of training
unless the applicant successfully completed a Fifth Pathway Program or has
served as a full-time assistant professor or in a higher position in an
approved school of medicine for a total of 36 months (A.R.S. �
32-1423
).
Fifth
Pathway Program
In addition to
completing the basic statutory requirements for medicine and surgery licensure
and when graduating from an unapproved allopathic school of medicine, an
applicant for a medical license who attended a foreign school of medicine and
successfully completed all the formal requirements to receive the degree of
Doctor of Medicine (M.D.) except internship or social service, and is
accordingly not eligible for certification by the
ECFMG
, may be considered for
licensure if they meet the following conditions: 1) satisfactorily completes an
approved Fifth Pathway Program of one academic year of supervised clinical
training under the direction of an approved U.S. school of medicine; and 2)
successfully completes an approved 24-month internship, residency or clinical
fellowship program upon completion of the Fifth Pathway Program. A document
granted by a foreign school of medicine signifying completion of all formal
requirements for graduation from such foreign medical school except internship
or social service training, or both, along with certification by the approved
U.S. school of medicine of successful completion of the Fifth Pathway Program
is deemed the equivalent of an M.D. for purposes of licensure and practicing as
a physician in Arizona (A.R.S. �
32-1424
).
Educational
Commission for Foreign Medical Graduates Pathway One
ECFMG is a
private, non-profit organization that evaluates the qualifications of
international medical graduates seeking to enter residency or fellowship
programs in the U.S. Pathway One was established for international medical
graduates who already hold or have held a license/ registration to practice
medicine without supervision in another country on or after January 1, 2021. Individuals
who have held only a license that requires supervised practice, such as a
training, resident, or restricted license, are not eligible for this Pathway. (
ECFMG � Pathway One
).
Provisions
1.
Requires an
applicant who has attended a school of medicine, has successfully completed all
formal graduation requirements and satisfied all requirements of Pathway One
through ECFMG to be granted a provisional medical license, if the applicant
meets all other applicable criteria. (Sec. 1, 3)
2.
Allows the
AMB to require an applicant for a provisional license to submit either or both
of the following:
a.
any
supporting application materials necessary to properly evaluate the applicant;
or
b.
medical
education information through ECFMG or another third-party records service, at
the applicant's expense. (Sec. 1)
3.
Specifies
that a provisional license must provide AMB:
a.
evidence of
substantially similar medical training that the AMB deems to be of equivalent
quality;
b.
evidence of
satisfactory passage of exams as determined by the AMB;
c.
proof of
certification by the ECFMG;
d.
a complete
license application; and
e.
payment of
all required licensing fees. (Sec. 1)
4.
Authorizes the
AMB to establish licensing and renewal fees for these provisional licenses. (Sec.
2)
5.
Requires
provisional licensees to both:
a.
work with a
physician who provides indirect supervision with direct supervision immediately
available, who practices in the same specialty as the provisional licensee; and
b.
comply with
the continuing education requirements and rules adopted for the provisional
license. (Sec. 2)
6.
Requires the
AMB to adopt rules relating to the supervision requirement, including:
a.
rules for
provisional licensees to submit the agreement to AMB,
b.
rules to
report to the AMB and to obtain medical malpractice liability insurance; and
c.
rules
regarding requirements for health insurance coverage and procedures for failing
to adhere to the terms of the supervision agreement. (Sec. 2)
7.
Requires
provisional licensees to be renewed annually. (Sec. 2)
8.
Requires the
employer of the provisional licensee to notify the AMB if the provisional
license is terminated or leaves employment for any reason. (Sec. 2)
9.
Requires the
AMB, within five days of notification from the employer, to terminate the
provisional license unless:
a.
the licensee
notifies AMB that the licensee is working for another employer in a county of
less than 1,000,000 persons; and
b.
the new
employer notifies AMB that the provisional licensee accepted the offer of
employment. (Sec. 2)
10.
Requires the
new employer to comply with AMB rules related to issuing a new supervision
agreement. (Sec. 2)
11.
Allows the
employer of a provisional licensee to require the license to take a competency
test at any time during employment. (Sec. 2)
12.
Permits the
AMB to discipline a provisional licensee or revoke a granted provisional
license after conducting a disciplinary action investigation. (Sec. 2)
13.
Permits an
international medical licensee to appeal the revocation of the provisional
license to the Maricopa County Superior Court (Superior Court). (Sec. 2)
14.
Requires the
Superior Court to reinstate the provisional license if the court finds that the
actions of the AMB did not meet the standards for revocation as outlined in
statute. (Sec. 2)
15.
Requires an
international medical provisional license to automatically be converted to a
full license to practice medicine in Arizona after four years if all the
following is met:
a.
the
provisional licensee engages in the practice of medicine in Arizona for four
years in a county with a population of less than 1,000,000 persons;
b.
the
provisional licensee is not disciplined by the AMB during that four-year period
of the provisional license; and
c.
the
provisional licensee's supervising physician with whom there was a supervision
agreement submits a signed attestation to the AMB certifying that it is a
supervising physician's professional opinion that the provisional licensee
meets Arizona's standards for providing medical care. (Sec. 2)
16.
Requires the
AMB to adopt rules regarding the format and submission requirements for the
supervising physician's attestation. (Sec. 2)
17.
Defines
terms. (Sec. 2)
18.
Makes
technical and conforming changes. (Sec. 1, 3)
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2435
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HB2435 - 572R - H Ver
House Engrossed
internationally
trained physicians; licensure
State of Arizona
House of Representatives
Fifty-seventh Legislature
Second Regular Session
2026
HOUSE BILL 2435
AN
ACT
Amending section 32-1424, Arizona
Revised Statutes; amending title 32, chapter 13, article 2, Arizona Revised
Statutes, by adding section 32-1424.01; amending section 32-1425,
Arizona Revised Statutes; relating to the Arizona medical board.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it
enacted by the Legislature of the State of Arizona:
Section 1. Section 32-1424, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1424.
Fifth pathway program; pathway one; licensure; provisional
licensure
A. In addition to the requirements for licensure
prescribed in sections 32-1422 and 32-1423, an applicant for
licensure under this article who attended a foreign school of medicine and
successfully completed all
the
formal requirements to
receive the degree of doctor of medicine except internship or social service,
and
who
is accordingly not eligible for certification by
the educational
council
commission
for foreign medical graduates, may be considered for licensure under this
chapter if the applicant meets the following conditions:
1. Satisfactorily completes an approved fifth
pathway program of one academic year of supervised clinical training under the
direction of an approved school of medicine in the United States.
2. Successfully completes an approved
twenty-four
month
twenty-four-month
internship,
residency or clinical fellowship program
upon
on
completion of the fifth pathway program.
B. A document granted by a foreign school of
medicine signifying completion of all
the
formal
requirements for graduation from
such
the
foreign medical school except internship or social service training, or both,
along with certification by the approved school of medicine in the United
States of successful completion of the fifth pathway program is deemed the
equivalent of a degree of doctor of medicine for purposes of licensure and
practice as a physician in this state.
C. Notwithstanding subsections A and
B of this section, an applicant for licensure who attended a school of
medicine, who successfully completed all formal requirements for graduation
from the school of medicine and who satisfies the requirements prescribed in
pathway one of the educational
commission for foreign
medical graduates shall be granted
a provisional license
if the applicant:
1. complies with subsections D and E
of this section and section 32-1424.01.
2. Holds a valid license to practice
medicine that does not require direct supervision.
3. Has a federal immigration status
that allows the person to work as a physician in the United States.
4. Has an offer for employment as a
physician in a county with a population of less than one million persons.
5. Meets the requirements for
licensure prescribed in section 32-1422, except for section 32-1422,
subsection A, paragraphs 1 and 2.
D. An applicant for a provisional
license pursuant to subsection C of this section shall provide the board with
all of the following:
1. Evidence of having substantially
similar medical training that the board deems to be of equivalent quality.
2. Evidence of satisfactorily passing
exams as determined by the board.
3. Proof of holding certification
from the educational commission for foreign medical graduates.
4. A complete license application.
5. Payment of all required licensing
fees.
E. The board may require an applicant
for a provisional license to submit either or both of the following:
1. Any supporting application
materials necessary for the board to properly evaluate the applicant.
2. At the applicant's expense,
medical education information through the educational commission for foreign
medical graduates or another third-party records service.
END_STATUTE
Sec. 2. Title 32, chapter 13, article 2,
Arizona Revised Statutes, is amended by adding section 32-1424.01, to read:
START_STATUTE
32-1424.01.
Provisional licensure; fees; supervision agreement; rules;
employment; discipline; conversion to full license; definitions
A. The board by rule may establish
licensing and renewal fees for provisional licensees. A provisional
license shall be renewed annually.
B. Each provisional licensee shall do
both of the following:
1. While licensed pursuant to section
32-1424, work with a physician who provides indirect supervision with
direct supervision immediately available, who practices in the same specialty
as the provisional licensee and who is licensed pursuant to chapter 13 or 17 of
this title. The board shall adopt rules relating to this supervision
requirement, including requirements for provisional licensees to submit the
supervision agreement to the board, to report to the board and to obtain
medical malpractice liability insurance and requirements regarding health
insurance coverage and procedures for failing to adhere to the terms of the
supervision agreement.
2. Comply with the continuing
education requirements prescribed in this chapter and the rules adopted
pursuant to this chapter.
C. A provisional licensee's employer
shall notify the board if the provisional licensee is terminated or leaves
employment for any reason. Within five days after receiving the notification
from the employer, the board shall terminate the provisional license unless the
provisional licensee notifies the board that the provisional licensee is
working for another employer in a county with a population of less than one
million persons and the new employer notifies the board that the provisional licensee
has accepted an offer of employment. The new employer shall comply
with board rules related to issuing a new supervision agreement.
D. The employer of a provisional
licensee may require the provisional licensee to take a competency test at any
time during employment.
E. The board may discipline a
provisional licensee or revoke a provisional license granted pursuant to
section 32-1424 after an investigation conducted pursuant to section 32-1451. An
international medical licensee may appeal the revocation of the provisional
license to the superior court in Maricopa county pursuant to title 12, chapter
7, article 6. The court shall reinstate the provisional license if the
court finds that the board's actions did not meet the standard prescribed in
section 32-1451.04.
F. A provisional license is
automatically converted to a full license to practice medicine in this state
after four years if all of the following are met:
1. The provisional licensee engages
in the practice of medicine in this state for four years in a county with a
population of less than one million persons.
2. The provisional licensee is not
disciplined by the board during the four-year period of provisional
licensure.
3. The supervising physician with
whom the provisional licensee has a supervision agreement submits a signed
attestation to the board certifying that it is the supervising physician's
professional opinion that the provisional licensee meets this state's standards
for providing medical care. The board shall adopt rules related to
the format and submission requirements for this attestation document.
G. For the purposes of this section:
1. "Indirect supervision with
direct supervision immediately available" means the supervising physician
is physically present within the hospital or other eligible entity site of
patient care and is immediately available to provide direct supervision of the
provisional licensee.
2. "Provisional licensee"
means an applicant who has been granted a provisional license pursuant to
section 32-1424, subsection C.
END_STATUTE
Sec. 3. Section 32-1425, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1425.
Initial licensure
A. An applicant who meets the applicable
requirements provided in section 32-1422, 32-1423 or 32-1424,
has passed steps one and two of the United States medical licensing examination
or one of the examination combinations prescribed in section 32-1426,
subsection A, paragraph 6, subdivision (c), items (i) and (ii), has paid the
fees required by this chapter and has filed a completed application found by
the board to be true and correct is eligible for licensure as a doctor of
medicine
upon
on
successful passage
of step three of the United States medical licensing examination with a scaled
score of at least seventy-five if the applicant has passed all three
steps within a
seven year
seven-year
period.
B. An applicant for licensure applying pursuant to
section 32-1422, 32-1423 or 32-1424 may take the examination
only after successfully completing six months of a
board approved
board-approved
hospital internship, residency or
clinical fellowship or fifth pathway program
or a pathway
prescribed in section 32-1424, subsection c
or serving as a full-time
assistant professor or in a higher position in a
board approved
board-approved
school of medicine in this state.
C. The board shall not grant a license until the
applicant meets the requirements for licensure pursuant to this chapter.
END_STATUTE